A Positron Emission Mammography/Tomography Biopsy Device

描述（由申请人提供）： 致密乳腺癌的检测是X射线乳腺摄影术的一个重大挑战。除了X射线不透明性之外，病变和周围乳腺组织密度之间的相似性限制了这些患者中小到中等大小肿瘤的有效检测。为了解决这一问题，基于核医学的成像技术，如正电子发射断层扫描（PET）与18 F-氟脱氧葡萄糖（FDG），已被应用于乳腺成像取得了一定的成功。这些方法依赖于肿瘤和正常组织之间代谢活动的差异，而不是用于创建图像的密度对比。虽然这些技术已经证明了在致密乳腺中检测乳腺病变的一些潜力，但它们有限的空间分辨率和特异性并不能保证它们唯一用于诊断。最有效的诊断方法仍然是从活检获得的组织样本的组织学评价。在许多情况下，X线乳腺摄影引导下的可疑病变的立体定向核心活检是一种有效的和微创的方法来执行这些程序。然而，在PET最佳检测致密乳腺病变的情况下，X射线技术可能不是活检引导的最佳选择。为了满足这一需求，我们提出了一种设备的建设，将能够获得高分辨率图像的乳房使用PET技术。然后，这些图像将用于评估放射性示踪剂摄取，并指导将活检针放置到可疑病变中。将通过采集一组立体定向平面正电子发射乳腺X射线摄影（PEM）图像，完成基于图像的针定位验证。这种称为PEM-PET的双模态系统将能够执行三个主要任务：病变检测、放射性示踪剂定量和病变定位。该装置将由两组旋转的大面积平面像素化闪烁体阵列组成。采用了旋转平面探测器（而不是更直观的环形几何结构），以便于在活检过程中进入乳房，同时允许采集PEM和PET图像。闪烁体材料（氧硅酸镥）和探测器像素尺寸的选择基于计算机模拟研究和模型观测器研究。该系统的开发将包括探测器单元的构造，以及断层摄影和平面图像重建方法的创建。PEM-PET系统将使用从模型和人类观察者研究以及临床前试验中获得的任务相关指标进行优化和评价。该项目完成后，将开发和评估一种用于乳房成像困难的妇女亚组的有效检测和诊断病变的仪器。

DESCRIPTION (provided by applicant): Detection of cancer in the dense breast is a significant challenge for x-ray mammography. Similarities between the density of lesions and surrounding breast tissue, in addition to x-ray opacity, limit effective detection of small to medium sized tumors in these patients. To address this concern, nuclear medicine-based imaging techniques, such as positron emission tomography (PET) used with 18F-Fluorodeoxyglucose (FDG), have been applied with some success to breast imaging. These methods rely upon differences in metabolic activity between tumor and normal tissue, instead of density contrasts for creating images. Although these techniques have demonstrated some potential in detecting breast lesions in dense breasts, their limited spatial resolution and specificity does not warrant their sole use for making diagnoses. The most effective method for diagnosis remains histological evaluation of tissue samples acquired from biopsy. In many cases stereotactic core biopsy of suspicious lesions guided by x-ray mammography is an effective and minimally-invasive method for performing these procedures. In the case of lesions optimally detected in a dense breast with PET, however, x-ray techniques may not be optimal for biopsy guidance. In response to this need, we propose the construction of a device that will be capable of acquiring high resolution images of the breast using PET techniques. These images will then be used to assess radiotracer uptake and guide the placement of a biopsy needle into suspicious lesions. Image-based verification of needle positioning will be accomplished by acquiring a set of stereotactic planar, positron emission mammography (PEM) images. This dual modality system called, PEM-PET, will be capable of performing three main tasks: lesion detection, radiotracer quantitation and lesion localization. The apparatus will consist of two sets of rotating, large-area planar pixelated scintillator arrays. The use of rotating planar detectors was adopted (instead of the more intuitive ring geometry) to facilitate access to the breast during biopsy procedures, while permitting acquisition of PEM and PET images. The choices of scintillator material (Lutetium Oxyorthosilicate) and detector pixel size were based on computer simulation studies and model observer studies. Development of the system will include the construction of the detector units, and the creation of tomopraphic and planar image reconstruction methods. The PEM-PET system will be optimized and evaluated with task-dependent metrics obtained from model and human observer studies, and a pre-clincal trial. At the completion of this project an apparatus for the effective detection and diagnosis of lesions for use in the subgroup of women with difficult to image breasts will have been developed and evaluated.